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Four Infective Tropical Fungal Diseases

By Katherine Harmon | December 11, 2011, www.scientificamerican.com

The tropics are a warm, wet and wonderful place for plant, animal and other life to flourish. In all of that diversity are some bizarre and fascinating parasites that make their living on—or at least find a temporary home in—us.

A session called “Adventures in Tropical Dermatology” last week at theAmerican Society of Tropical Medicine and Hygiene’s annual meeting(ASTMH) in Philadelphia featured a collection of slides depicting conditions that would be enough to anchor anyone to the temperate zone, come hell or high water. But the organisms that resulted in the frequently grotesque images were impressive examples of incredible adaptation or revealing of surprising gaps in human defenses.

The following are some of the highlights—which, for the brave, are just a Google search away.

Four infective fungi

One of the more entrancing slides showed a man’s shoulder covered in rounded, off-white concentric ovals, tracing a path that spread over the chest and back, almost like coral. The infection, known as tinea imbricata, is caused by the fungus Trichophyton concentricum, which lives primarily in Southeast Asia, Central and South America and the South Pacific.

A second fungus that has made its way up from the tropics as far north as North Carolina is Lacazia loboi, which causes the skin infection lobomycosis. The more northerly carriers of the fungal infections so far have been bottlenose dolphins; in humans, the infection is still primarily limited to Central and South America. The fungal spores can enter the body through a skin abrasion, such as a scratch or bug bite. The human immune system, however, does not seem to mount a defense against the invader, leaving it relatively free to spread in the body and create a fungal network of bumps under the skin.

Another tropical fungal escapee is chromoblastomycosis, which is often caused by one of four types of fungi that are commonly found breaking down plant matter in forests. This infection is often kicked off by a splinter and once inside the body, “we really elicit no defense or immunological response,” Scott Norton, of Georgetown University Hospital, said at the ASTMH meeting. Although cases are mainly confined to warm climates, there have been some cases reported in northern Asia and Europe, including some from old Finnish saunas.

Splinters or other puncturing objects can also be the vector for eumycetoma, another fungal disease against which the human body does not mount much of an immune response, Norton noted. The implanted, unchecked fungus, which might be one of many species, “can grow so luxuriantly that it can become a whole colony,” he said. Eventually, the infected area—often the foot or hand of agricultural workers—will swell and begin to extrude grains of different colors depending on the species of infecting fungus.